Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection

Alimentary Pharmacology and Therapeutics, 10/18/2011

Bavishi C et al. – Severe hypochlorhydria generated by proton pump inhibitors(PPI) use leads to bacterial colonisation and increased susceptibility to enteric bacterial infection. The clinical implication of chronic PPI use among hospitalized patients placed on antibiotics and travellers departing for areas with high incidence of diarrhoea should be considered by their physicians.

This study describes the available evidence for enhanced susceptibility to enteric infection caused by Salmonella, Campylobacter and C. difficile by PPI use, with adjusted relative risk ranges of 4.2–8.3 (two studies); 3.5–11.7 (four studies); and 1.2–5.0 (17 of 27 studies) for the three respective organisms.